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The human brain does not fully mature until the
early twenties. Among the last areas to develop
are those that govern impulse control and
planning. So what might that mean for teens?
On one hand, they may be more adventurous
than adults, willing to take chances…on
the other, this could involve risky behaviors,
including drug use.
The trick is to find ways to encourage your
kids to be the unique individuals they are,
without exposing themselves to the dangers of
experimenting with drugs—including marijuana.
Talking openly about it is a good start.
Tips for
Parents
UÊ Be a good listener.
UÊ Give clear no-use messages about
drugs and alcohol.
UÊ Help your child deal with peer
pressure to use drugs.
UÊ Get to know your child’s friends
and parents.
UÊ Monitor your child’s whereabouts.
UÊ Supervise teen activities.
—Nora D. Volkow, NIDA Director
UÊ Talk to your child often.
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Since 1975 the Monitoring the Future (MTF) survey has measured drug,
alcohol, and cigarette use and related attitudes among adolescent students
nationwide. Drug use is measured across three time periods: lifetime, past
year, and past month; for some drugs, daily use is also reported. Initially,
the survey included 12th-graders only, but in 1991 it was expanded to
include 8th- and 10th-graders.
Marijuana remains the most abused illicit substance among
youth. By the time they graduate high school, about 44 percent
of U.S. teens will have tried marijuana at least once in their
lifetime. Although use among teens has dropped dramatically
in the past decade (to a prevalence of about 15 percent for pastmonth use in 2010), this decline has stalled and, in fact, may
now be on the upswing. Recent survey data show that daily
marijuana use is up among students in 8th, 10th, and 12th
grades, compared to the year prior. A principal reason is that
today's teens have come to view marijuana as less dangerous than
before—even among 8th-graders, whose marijuana use increased
1
Marijuana: Facts Parents Need to Know
We at the National Institute on Drug Abuse (NIDA) are pleased
to offer these two short booklets for parents and children to
review the scientific facts about marijuana: (1) Marijuana:
Facts Parents Need to Know and (2) Marijuana: Facts for Teens.
Although it is best to talk about drugs when children are
young—since that is when drug use often begins—it is never too
late to start.
Marijuana: Facts Parents Need to Know
2
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across past-year, past-month, and daily measures. These statistics
were taken from the 2010 Monitoring the Future Survey, which
has been tracking teen attitudes and drug use since 1975.
Survey results show that we still have a long way to go in our
efforts to prevent marijuana use and avoid the toll it can take
on a young person’s life. NIDA recognizes that parents have an
important role in this effort and can strongly influence their
children’s attitudes and behaviors. However, the subject of
marijuana use has become increasingly difficult to talk about—
in part, because of the mixed messages being conveyed by
the passage of medical marijuana laws and calls for marijuana
legalization in certain States. In addition, many parents of today’s
teens may have used marijuana when they were younger, which
could make talking openly and setting definitive rules about its
use more difficult.
Talking to our children about drug abuse is not always easy, but
it is crucial. You can also get involved in your community and
seek out drug abuse prevention programs that you and your
child can participate in together. Sometimes, just beginning the
conversation is the hardest part. I hope these booklets can help.
Nora D. Volkow, M.D.
Director
National Institute on Drug Abuse
A Letter to Parents
1
I. Talking to Your Kids—Communicating the Risks
5
Why do young people use marijuana?
How can I prevent my child from using marijuana?
Marijuana is addictive
Marijuana is unsafe if you are behind the wheel
Marijuana is associated with school failure
High doses of marijuana can cause psychosis or
panic during intoxication
II. Want to Know More?—Some FAQs About Marijuana
What is marijuana? Are there different kinds?
How is marijuana used?
How many people use marijuana?
How does marijuana work?
What are marijuana’s short-term effects?
What determines how marijuana affects an individual? How
important is marijuana potency?
Does using marijuana lead to other drug use?
Does smoking marijuana cause lung cancer?
Since marijuana is addictive, does it produce withdrawal
symptoms when someone quits using it?
Are there treatments for people addicted to marijuana?
What are other risks related to marijuana that my child
should be aware of?
How can I tell if my child has been using marijuana?
5
6
6
7
7
7
9
9
9
10
11
12
14
15
16
17
17
18
20
III. Starting the Conversation
23
IV. Other Useful Resources
27
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Introduction
Why do young people use marijuana? Children and teens start
using marijuana for many reasons. Curiosity and the desire to
fit into a social group are common ones. Some have a network
of friends who use drugs and urge them to do the same (peer
pressure). Those who have already begun to smoke cigarettes
and/or use alcohol are at heightened risk for marijuana use
as well. And children and teens who have untreated mental
disorders (e.g., ADHD, conduct disorder, anxiety) or who were
physically or sexually abused are at heightened risk of using
marijuana and other drugs at an early age.
For some, drug use begins as a means of coping—to deal with
anxiety, anger, depression, boredom, and so forth. But in fact,
being high can be a way of simply avoiding the problems and
challenges of growing up. Research also suggests that family
members’ use of alcohol and drugs plays a strong role in whether
children/teens start using drugs—making parents, grandparents,
and older brothers and sisters models for children to follow.
So indeed, all aspects of a teen’s environment—home, school,
neighborhood—can help determine whether they will try drugs.
5
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
4
How can I prevent my child from using marijuana? There is no
magic bullet for preventing teen drug use. But research indicates
that parents have a big influence on their teens, even when
it doesn’t show! So talk openly with your children and stay
actively engaged in their lives. To help you get started, below are
some brief summaries of marijuana research findings that you
can share with your kids to help them sort out fact from myth,
and to make the best decisions they can based on the current
evidence. These were chosen because they reflect the questions
and comments that we receive from teens every day on our teen
Web site and blog—what teens care about. Following this brief
summary of research highlights, FAQs and additional resources
are provided to equip you with even more information.
DID YOU KNOW….
Marijuana is addictive. Repeated marijuana use can lead to
addiction—which means that people often cannot stop when
they want to, even though it undermines many aspects of
their lives. Marijuana is estimated to produce addiction in
approximately 9 percent, or roughly 1 in 11, of those who use it
at least once. This rate increases to about 1 in 6, or 16 percent,
for users who start in their teens, and 25–50 percent among daily
users. Moreover, 4.3 million of the more than 7 million people
who abused or were addicted to any illicit drug in 2009 were
dependent on marijuana. And among youth receiving substance
abuse treatment, marijuana accounts for the largest percentage
of admissions: 63 percent among those 12–14, and 69 percent
among those 15–17.
Marijuana is UNSAFE if you are behind the wheel. Marijuana
compromises judgment and affects many other skills required for
safe driving: alertness, concentration, coordination, and reaction
time. Marijuana use makes it difficult to judge distances and
react to signals and sounds on the road. Marijuana is the most
commonly identified illicit drug in fatal accidents (~14 percent of
drivers), sometimes in combination with alcohol or other drugs.
In fact, even small amounts of alcohol, when combined with
marijuana use, can be very dangerous—more so than either one
alone.
Marijuana is associated with school failure. Marijuana’s negative
effects on attention, motivation, memory, and learning can last
for days and sometimes weeks after its immediate effects wear
off—especially in chronic users. Someone who smokes marijuana
daily may be functioning at a reduced intellectual level most or
all of the time. Compared with their nonsmoking peers, students
who smoke marijuana tend to get lower grades and are more
likely to drop out of high school. Long-term marijuana users
report decreased overall life satisfaction, including diminished
mental and physical health, memory and relationship problems,
lower salaries, and less career success.
High doses of marijuana can cause psychosis or panic during
intoxication. Although scientists do not yet know whether the
use of marijuana causes chronic mental illness, high doses can
induce an acute psychosis (disturbed perceptions and thoughts,
including paranoia) and/or panic attacks. In people who already
have schizophrenia, marijuana use can worsen psychotic
symptoms, and evidence to date suggests a link between early
marijuana use and an increased risk of psychosis among those
with a preexisting vulnerability for the disease.
7
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
6
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H%What is marijuana? Are there different kinds?
8%Marijuana is a green, brown, or gray mixture of dried,
shredded leaves, stems, seeds, and flowers of the hemp plant
(Cannabis sativa). Cannabis is a term that refers to marijuana and
other drugs made from the same plant. Strong forms of cannabis
include sinsemilla (sin-seh-me-yah), hashish (“hash” for short),
and hash oil. There are many different slang terms for marijuana
and, as with other drugs, they change quickly and vary from
region to region. But no matter its form or label, all cannabis
preparations are mind-altering (psychoactive) because they all
contain THC (delta-9-tetrahydrocannabinol). They also contain
more than 400 other chemicals.
H%How is marijuana used?
8%Most users roll loose marijuana into a cigarette (called a
joint or a nail) or smoke it in a pipe or a water pipe, sometimes
referred to as a bong. Some users mix marijuana into foods, or
use it to brew a tea. Another method is to slice open a cigar and
replace the tobacco with marijuana, creating what is known as
a blunt. Marijuana cigarettes or blunts sometimes are dipped in
PCP or mixed with other substances, including crack cocaine.
9
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
8
H%How many people use marijuana?
8%Before the 1960s, many Americans had never heard of
marijuana, but today it is the most often used illegal drug in the
United States. According to a 2009 national survey, more than
104 million Americans over the age of 12 had tried marijuana
at least once, and almost 17 million had used the drug in the
month before the survey.
Researchers have found that the use of marijuana and other
drugs usually peaks in the late teens and early twenties, and then
declines in later years. Therefore, marijuana use among young
people remains a natural concern for parents and the focus of
continuing research, particularly regarding its impact on brain
development, which continues into a person’s early twenties.
NIDA's annual Monitoring the Future Survey reports that among
students from 8th, 10th, and 12th grades, most measures of
marijuana use have decreased over the past decade; however,
this decline has stalled in recent years as attitudes have softened
about marijuana’s risks. In 2009, 11.8 percent of 8th-graders
reported marijuana use in the past year, and 6.5 percent were
current (past-month) users. Among 10th-graders, 26.7 percent
had used marijuana in the past year, and 15.9 percent were
current users. Rates of use among 12th-graders were higher still:
32.8 percent had used marijuana during the year prior to the
survey, and 20.6 percent (or about 1 in 5) were current users.
H%How does marijuana work?
8%When marijuana is smoked, its effects are felt almost
immediately. This is because THC (marijuana's psychoactive
ingredient) rapidly reaches every organ in the body, including
the brain. The effects of smoked marijuana can last from 1 to 3
hours. If consumed in foods, the effects come on slower and may
not last as long.
Marijuana works through THC attaching to specific sites on
nerve cells in the brain and in other parts of the body. These
sites are called cannabinoid receptors (CBRs) since they were
discovered by scientists trying to understand how marijuana,
or cannabis, exerts its effects. THC is chemically similar to
a class of chemicals that our body produces naturally, called
endocannabinoids, and marijuana disrupts the normal function
of this system. CBRs are found in brain areas that influence
pleasure, memory, thinking, concentration, movement,
coordination, appetite, pain, and sensory and time perception.
Because of this system’s wide-ranging influence over many critical
functions, it is not surprising that marijuana can have multiple
effects—not just on the brain, but on a user’s general health
as well. Some of these effects are related to acute intoxication
while others may accumulate over time to cause more persistent
problems, including addiction.
11
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
10
H%What are marijuana’s short-term effects?
8%The following are some effects that marijuana use can
produce:
UÊ Euphoria (high). THC activates the reward system in the
same way that nearly all drugs of abuse do: by stimulating
brain cells to release the chemical dopamine.
UÊ Memory impairment. THC alters how information is
processed in the hippocampus, a brain area responsible
for memory formation, causing problems with short-term
memory as well as difficulty with complex tasks requiring
sustained attention/concentration. Prolonged use could
therefore affect learning skills and academic achievement.
UÊ Increased appetite (“munchies”).
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UÊ Increased heart rate.
UÊ Dilation (expansion) of the blood vessels in the eyes, making
them look red or bloodshot.
UÊ Adverse mental reactions in some. These include anxiety,
fear, distrust, or panic, particularly in those who are new
to the drug or who are taking it in a strange setting; and
acute psychosis, which includes hallucinations, delusions,
paranoia, and loss of the sense of personal identity.
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13
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
12
H%What determines how marijuana affects an
individual? How important is marijuana potency?
8%Like any other drug, marijuana’s effects on an individual
depend on a number of factors, including the person’s previous
experience with the drug (or other drugs), biology (e.g., genes),
gender, how the drug is taken (smoked versus orally), and the
drug’s potency. Potency—determined by the amount of THC
contained in the marijuana—has received much attention
lately because it has been increasing steadily. In 2009, THC
concentrations in marijuana averaged close to 10 percent,
compared to around 4 percent in the 1980s. This is based on
analyses of marijuana samples confiscated by law enforcement
agencies. So what does this actually mean? For a new user, it may
mean exposure to higher concentrations of THC, with a greater
chance of an adverse or unpredictable reaction. In fact, increases
in potency may account for the rise in emergency department
visits involving marijuana use. For experienced users, it may
mean a greater risk for addiction if they are exposing themselves
to high doses on a regular basis. However, the full range of
consequences associated with marijuana’s higher potency is not
well understood, nor is it known whether marijuana users adjust
for the increase in potency by using less.
drug use show that most young people who use other drugs
have tried marijuana, alcohol, or tobacco first. That said, many
young people who use marijuana do not go on to use other
drugs. It is clear that more research is needed to determine who
is at greatest risk. For example, the risk of young people using
cocaine is much greater for those who have tried marijuana than
for those who have not (though teen cocaine use is low overall).
We also know from animal studies that when rats are exposed to
cannabinoids their brain reward system becomes less sensitive,
or responsive, to that drug, which means that they would need
more of the drug to achieve the same effect. An important aspect
of this effect is a phenomenon called cross-tolerance (the ability
of one drug to reduce responsiveness to a different drug). This
was only seen if the rats that were given cannabinoids were
young (e.g., adolescent) at the time of exposure. Prompted by the
results of this animal study, researchers are now examining the
possibility that early exposure to marijuana (e.g., in adolescence)
may induce changes in the brain that make a person more
vulnerable to subsequent marijuana addiction or to the risk of
becoming addicted to other drugs, such as alcohol, opioids,
or cocaine. It is important to point out, however, that research
has not fully explained any of these effects, which are complex
and likely to involve a combination of biological, social, and
psychological factors.
15
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
H%Does using marijuana lead to other drug use?
8%Long-term studies of high school students’ patterns of
14
H%Since marijuana is addictive, does it produce
withdrawal symptoms when someone quits
using it?
8%For many years, this was a subject of debate; but researchers
H%Does smoking marijuana cause lung cancer?
8%We do not know yet. Studies have not found an increased
risk of lung cancer in marijuana smokers, as compared with
nonsmokers. However, marijuana smoke does irritate the lungs
and increases the likelihood of other respiratory problems through
exposure to carcinogens and other toxins. Repeated exposure
to marijuana smoke can lead to daily cough and excess phlegm
production, more frequent acute chest illnesses, and a greater
risk of lung infections. Marijuana also affects the immune system,
although the implications for cancer are unclear. Moreover, many
people who smoke marijuana also smoke cigarettes, which do
cause cancer, and quitting tobacco can be harder if the person
uses marijuana as well.
have clearly characterized a set of symptoms that many long-term
users experience when they stop using the drug. The symptoms
are similar in type and severity to those of nicotine withdrawal—
irritability, sleeping difficulties, anxiety, and craving—which
often prompt relapse. Withdrawal symptoms peak a few days
after use has stopped and dissipate within about 2 weeks. And
while these symptoms do not pose an immediate threat to the
health of the user, they can make it hard for someone to remain
abstinent.
H%Are there treatments for people addicted
to marijuana?
8%
Currently, no FDA-approved medications exist for treating
marijuana addiction, although promising research is under
way to find medications for treating withdrawal symptoms and
alleviating craving and other subjective effects of marijuana.
Behavioral therapies are available and are similar to those
used for treating other substance addiction. These include
motivational enhancement to engage people in treatment;
cognitive behavioral therapies to teach patients strategies for
avoiding drug use and its triggers and for effectively managing
stress; and motivational incentives, which provide vouchers or
small cash rewards for sustained drug abstinence. Unfortunately,
treatment success rates are rather modest, indicating that
marijuana addiction, like other addictions, may need a chronic
care approach that varies treatment intensity in line with the
person’s changing needs over time.
17
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
16
H%What are other risks related to marijuana that my
child should be aware of?
8%Here are a few that you or your child may not have thought
about:
UÊ As with most drugs, marijuana use compromises judgment,
which can mean a greater likelihood of engaging in risky
behaviors and experiencing their negative consequences
(e.g., acquiring a sexually transmitted disease, driving while
intoxicated, or riding with someone else who is intoxicated
and getting into a car crash).
UÊ In addition to psychosis, chronic marijuana use has been
associated with an array of psychological effects, including
depression, anxiety, suicidal thoughts, and personality
disturbances. One of the most frequently cited is an
“amotivational syndrome,” which describes a diminished
or lost drive to engage in formerly rewarding activities.
Whether this disorder occurs unto itself or is a subtype
of depression associated with marijuana use remains
controversial, as does the causal influence of marijuana.
However, because of the endocannabinoid system’s role in
regulating mood, these associations seem plausible. More
research is needed to confirm and better understand these
linkages.
UÊ Marijuana use during pregnancy may adversely affect the
fetus. Animal research suggests that the endocannabinoid
system plays a role in the control of brain maturation,
particularly the development of emotional responses. In
humans, the data are less conclusive—in part, because it
is difficult to disentangle the drug-specific factors from the
environmental ones. For example, pregnant women who use
marijuana may also smoke cigarettes or drink alcohol, both
of which can affect fetal development. Nevertheless, research
suggests that babies born to women who used marijuana
during their pregnancies may have subtle neurological
alterations and, as children, can show diminished
problemsolving skills, memory, and attentive processes.
Although, the extent to which these effects reflect marijuana
use or other drugs is unclear.
19
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
18
H%How can I tell if my child has been using
marijuana?
8%Parents should be aware of changes in their child’s behavior,
such as carelessness with grooming, mood changes, and
deteriorating relationships with family members and friends.
In addition, changes in academic performance, increased
absenteeism or truancy, lost interest in sports or other favorite
activities, and changes in eating or sleeping habits could all be
related to drug use—or may indicate other problems. See text
box for a more detailed list of warning signs.
If someone is high
on marijuana,
he or she might:
UÊ seem dizzy or uncoordinated;
UÊ seem silly and giggly for no reason;
UÊ have very red, bloodshot eyes;
UÊ have a hard time remembering things
that just happened;
UÊ be in possession of drugs and drug
paraphernalia, including pipes and
rolling papers;
UÊ have an odor on clothes and in the
bedroom;
UÊ use incense and other deodorizers;
UÊ use eye drops;
UÊ wear clothing or jewelry or have posters
that promote drug use; or
UÊ have unexplained use of money.
21
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
20
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As this booklet has shown, marijuana can pose a particular threat
to the health and well-being of children and adolescents at a
critical point in their lives—when they are growing, learning,
maturing, and laying the foundation for their adult years. As
a parent, your children look to you for help and guidance in
working out problems and in making decisions, including the
decision not to use drugs. Even if you have used drugs in the
past, you can have an open conversation about the dangers.
Divulging past drug use is an individual decision, but having
used drugs should not prevent you from talking to your child
about the dangers of drug use. In fact, experience can better
equip us to teach others, including drawing on the value of
possible mistakes.
Greater acceptance of marijuana use, compared with use of
other illicit drugs, continues to underlie divergent opinions
about its dangers, illegality, and potential value. Indeed, the
ongoing public debate about smoking marijuana to ameliorate
a wide range of ills—from pain and nausea to anxiety and sleep
23
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
22
disturbances—may complicate your discussion. However, as
you have read, marijuana also has liabilities and as a medicinal
formulation is not ideal. It contains numerous other compounds
with unknown health effects; plus, smoking as a delivery
method clearly is not optimal for lung health. Scientists continue
to investigate the medicinal properties of THC and other
cannabinoids to better evaluate and harness their ability to
help patients suffering from a broad range of conditions, while
avoiding the adverse effects of smoked marijuana.
Meanwhile, marijuana use can be particularly dangerous
for adolescents and can alter the trajectory of a young life,
diminishing a person’s full potential. And that is reason enough
to have this sometimes difficult conversation with your children.
We hope this booklet can serve as a catalyst and helpful guide to
beginning the dialogue and, more importantly, continuing it and
keeping the channels of communication open.
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Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
24
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There are numerous resources, many right in your own
community, where you can obtain information to help you talk
to your children about drugs. Consult your local library, school,
or community service organization. You may also contact the
governmental organizations listed below.
National Institute on Drug Abuse (NIDA)
NIDA's mission is to lead the Nation in bringing the power of
science to bear on drug abuse and addiction. This charge has
two critical components. The first is the strategic support
and conduct of research across a broad range of disciplines.
The second is ensuring the rapid and effective dissemination
and use of the results of that research to inform policy and
improve practice.
NIDA offers an extensive collection of publications,
videotapes, and educational materials to help parents talk
to their children about drug use. For general inquiries, contact
NIDA's public information office at 301-443-1124 or visit the
NIDA Web site at www.drugabuse.gov. For more information
on marijuana and other drugs, visit www.marijuana-info.org
and www.teens.drugabuse.gov. All NIDA publications are
available free of charge through the NIDA DRUGPUBS Research
Dissemination Center (http://drugpubs.drugabuse.gov;
e-mail [email protected]; or phone 1-877-NIDA-NIH
[1-877-643-2644] or 1-240-645-0228).
27
Marijuana: Facts Parents Need to Know
Marijuana: Facts Parents Need to Know
26
Marijuana: Facts Parents Need to Know
28
Substance Abuse and Mental Health Services
Administration (SAMHSA)
SAMHSA provides valuable information on its Web site,
including resources for finding substance abuse treatment. Its
treatment locator (http://findtreatment.samhsa.gov/) can help
you find a drug abuse or alcohol treatment program near you.
Visit http://www.samhsa.gov for more information on drug abuse
prevention and treatment policies, programs, and services.
National Institute of Mental Health (NIMH)
NIMH provides numerous resources covering a variety of mental
health disorders, which often co-occur with drug abuse and
addiction. Visit www.nimh.nih.gov to access the latest research
findings and other helpful mental health information.
National Institute on Alcohol Abuse and Alcoholism
(NIAAA)
NIAAA conducts and supports research across many scientific
areas, coordinating with other institutes on alcohol-related issues,
which frequently intersect with other drug abuse/addiction
problems. Visit http://www.niaaa.nih.gov/ for information on a
variety of alcohol-related topics.
Feel free to reprint this publication in any quantity you wish.